| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EBENCONCEPTS COMPANY3 | 921-C S. MCPHERSON CHURCH ROAD FAYETTEVILLE, NC 28303 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $27K | $14K | $41K | 15.00% |
| EBENCONCEPTS COMPANY3 | 639 EXECUTIVE PL STE 202 FAYETTEVILLE, NC 28305 | PRINCIPAL LIFE INSURANCE COMPANY | $17K | $11K | $28K | 15.97% |
| MOSAIC GROUP SERVICES3 Filed as: MOSAIC GROUP SERVICES LLC | PO BOX 2291 DURHAM, NC 277022291 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | $686 | $9K | 4.84% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD OF NC EIN 56-0894904 TPA | Claims processing Service code 12 | — | $78K |
| EBENCONCEPTS EIN 75-2966596 CONSULTANT | Consulting fees; Consulting (general) Service code 16 | — | $23K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 195 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 195 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 194 | $176K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 194 | $176K |
| Life insurance(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 194 | $449K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 182 | $274K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 182 | $274K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA | 195 | $375K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 182 | $274K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 195 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.